Have you noticed any generational differences in how people cope with stress?

 

Building mental Health Resilience in health care teams.

Dr. C.V. Alert MB BS, DM, FCCFP.

Family Physician.

 

The term ‘resilience’ primarily reflects the capabilities of a system to absorb and recover from disturbances. Mental health resilience is crucial for effective teamwork in healthcare, and mentally strong doctors are essential for success of any health care system. Mental health resilience is a cornerstone of effective teamwork. Doctors must be able to discuss difficult issues, such as difficult diagnoses, without fear of repercussions. Inaccurate information or hesitation in these areas can have serious consequences. This requires an appropriate health environment, which is not a hypothetical construct but must be created.

Healthcare systems need to focus on both individual coping mechanisms, as well as creating a supportive work environment. Personal wellness means being physically, mentally and spiritually healthy. A healthy lifestyle helps balance all these aspects to achieve wellness. This includes activities like getting adequate sleep, eating healthy, avoiding drinking and smoking, and engaging in physical activity. To cultivate resilience in your life, it's important to apply the principles of the 7 Cs:  competence, confidence, connection, character, contribution coping and control.

On the other hand, lower resilience often stems from taking on (or being forced to take on) too much too fast. If you don't have faith in yourself or your abilities, or faced with an overwhelming situation, you’re less likely to adapt to stressful situations.

Here lies the catch-22 situation, for Caribbean Health professionals. Facing large workloads in under-resources clinics, many health care professionals are forced to take on too many patients, often with little or no support.  Mental health support? Just a rumor, as in many cases there is little recognition of the need to have supportive services, especially mental health services, available to health care professionals. ‘Only the strong survive, the weak fall by the wayside” : if individuals don’t develop personal coping mechanisms, then historically health care systems in the Caribbean are not designed to provide any assistance.

Violence, unfortunately in a prominent feature in many Caribbean islands- in two islands violence appears in the top 5 leading causes of death, and in most Caribbean islands the frequency and severity of violent acts is increasing; local health care providers are often called on to become involved, whether the involvement involves the perpetrator, the victim, family members, or even the security services. In rarer circumstances, the health care provider is himself/herself the victim of a violent act. But where is the support for the health care provider?

Dealing with dying patients and their families is another area of great mental challenge for physicians.

Associations such as the Caribbean College of Family Physicians (CCFP), and other groupings of health care providers, should not only consider advising its members to attend resilience training seminars, but to actually organize such seminars, even inviting other groups of health care professionals to participate.

Resilience training aims to teach how to adapt to stressful or dangerous events. It gives you tools to handle problems that arise on a daily basis. Being more resilient can improve quality of life, increase emotional strength, and lessen stress and worry. Teaching and prioritizing self-care to all family physicians should be also standard practice and supported throughout their careers.

Support must also go beyond workshops. There should be policies that specify adequate staffing targets to minimize exhaustion and burnout. Access to mental health services is also mandatory where family doctors can voluntarily seek psychological support.

Lastly creating a culture of psychological safety and support among peers will also help.

Psychological Safety?

 

Psychological safety is defined as the belief that one can take interpersonal risks without fear of being ridiculed or penalized. It allows team members to:

·         Ask questions without being seen as incompetent

·         Admit mistakes without fearing punishment

·         Raise concerns without being labeled as disruptive

·         Seek help without feeling embarrassed.

 

Psychological Safety benefits.

 

·         Better clinical decisions: Teams where junior doctors and nurses can express concerns without fear of negative consequences make more accurate diagnoses and prevent errors early.

·         Stronger team dynamics: A leader who sees themselves as a listener fosters trust within the team. Those open to feedback often receive critical information in time, preventing undesirable events.

·         Role modeling and sustainable leadership: Leaders who admit their own mistakes create a culture of mutual respect and foster a transparent, learning organization.

·         Error management as an opportunity: Errors are inevitable. What matters is how they are handled. A culture that views mistakes as learning opportunities improves both safety and team innovation. Experienced doctors and leaders who consciously strengthen psychological safety in their teams benefit in the long run through higher employee satisfaction, and improved patient safety.

 

Implementation in Clinical Practice.

 

Implementing psychological safety in healthcare requires action at multiple levels:

 

·         Individual level:

Personal communication skills development

Training in emotional regulation and conflict resolution

Feedback competency building

 

·         Team level:

Daily team reflection huddles

Leadership training at all levels.

Structured handovers with communication standards

Regular team reflection rounds

“Closed-loop communication” to reduce misunderstandings

Anonymous reporting systems for safety issues

 

·         Organizational level:

Regular interdisciplinary case discussions

Standardized communication processes

Speak-up protocols for critical situations

Cross-hierarchy meeting formats

Simulation training to improve error communication

Call to action.

 

Development of psychological safety is a continuous process that requires time, commitment, and resources. A lived culture of mistakes, where employees can communicate openly and without fear, is the key success factor for resilient high-performance teams in medicine and aviation.